You Pay Medicare Premiums Even While on SSDI

Yes, you pay Medicare premiums once you are enrolled in Medicare through SSDI. The Social Security Administration does not waive these costs because you receive disability benefits. Your premiums are deducted directly from your SSDI payment each month, so the money never reaches your bank account — it goes straight to Medicare.

The amount you pay depends on which Medicare parts you have and your income level. Most people on SSDI are automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance) after 24 months of receiving SSDI payments. Part A has no monthly premium for most people, but Part B does. Part D (prescription drug coverage) is optional and carries its own premium if you choose it.

Your premiums can change each year. The Social Security Administration announces new Medicare Part B and Part D premiums in October, and they take effect the following January. If your income is higher, you may pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA), which increases your Part B and Part D costs.

Key Takeaways

  • Medicare premiums are deducted from your SSDI payment each month, reducing the amount you receive in your bank account.
  • Part A (hospital insurance) typically has no monthly premium, but Part B (medical insurance) does, and the amount changes yearly.
  • If your income exceeds certain thresholds, you will pay higher premiums through an Income-Related Monthly Adjustment Amount.
  • Part D (prescription drug coverage) is optional, and you only pay a premium if you enroll in a plan.

How Much You Pay for Part B

The standard Part B premium amount changes each year. In 2024, the standard premium was $164.90 per month, but this figure varies annually based on program costs. You can find the current year's premium on the Medicare.gov website or by calling Social Security at 1-800-772-1213.

If you enroll in Part B late — meaning you did not sign up when you first became may be able to access — you may pay a late enrollment penalty. This penalty is a percentage increase added to your premium for as long as you have Part B coverage. The penalty is calculated based on how many months you delayed enrollment after you became may be able to access.

Some people with very low income may pay a reduced Part B premium or no premium at all through the Medicare Savings Program, which is run by your state. This program is separate from SSDI and requires a separate process. You must meet income and resource limits set by your state to may have access to.

Part A Premium and Hospital Coverage

Most people who receive SSDI do not pay a monthly premium for Part A because they have enough work credits from their own work history or their spouse's work history. Part A covers hospital stays, skilled nursing facility care, hospice, and some home health services.

If you do not have enough work credits to may have access to for premium-free Part A, you can purchase Part A coverage. The monthly premium for Part A in 2024 was either $278 or $505 per month depending on how many work credits you had accumulated, but these amounts change yearly. Again, check Medicare.gov or call Social Security for the current year's amount.

Part D Prescription Drug Coverage Costs

Part D is optional coverage for prescription medications. You do not have to enroll in Part D when you first become may be able to access for Medicare, but if you delay enrollment without having other creditable drug coverage, you will pay a late enrollment penalty when you do sign up. This penalty is permanent and calculated based on how many months you went without coverage.

Part D premiums vary widely depending on which insurance company's plan you choose. Plans are offered by private insurers, and each plan has a different premium, deductible, and list of covered drugs. You can compare plans on Medicare.gov using their Plan Finder tool. The average Part D premium in 2024 was around $34 per month, but individual plans range much higher or lower.

If you have limited income, you may pay reduced or no Part D premiums through the Low-Income Subsidy (LIS) program, also called "Extra Help." This program is administered by Social Security, and you can explore by calling 1-800-772-1213 or visiting your local Social Security office.

Income-Related Monthly Adjustment Amounts (IRMAA)

If your income is above certain thresholds, Medicare charges you higher premiums for Part B and Part D. These additional charges are called IRMAA. Your income is measured using your Modified Adjusted Gross Income (MAGI) from two years prior. For example, in 2024, Medicare uses your 2022 income to calculate your 2024 IRMAA.

The income thresholds and surcharge amounts change each year. In 2024, if you were a single filer with income over $97,000, you began paying IRMAA. Married couples filing jointly with income over $194,000 also paid IRMAA. The surcharges ranged from $70.30 to $560.50 per month for Part B, depending on income level, and similar increases applied to Part D.

If your income drops — because you lost a job, had a major life change, or your SSDI payment decreased — you can request that Medicare recalculate your IRMAA. This is called a Life-Changing Event appeal. You must report the change to Social Security within 60 days and provide documentation of the event.

How Premiums Are Deducted From Your SSDI Payment

Your Medicare Part B and Part D premiums are automatically deducted from your SSDI payment before the money is deposited into your account. This means your actual monthly SSDI deposit is lower than your benefit amount. For example, if your SSDI benefit is $1,200 and your Part B premium is $164.90, you receive $1,035.10 in your account.

You cannot opt out of this deduction. If you want to stop paying for Part B or Part D, you must formally disenroll from that part of Medicare. However, disenrolling from Part B or Part D may result in late enrollment penalties if you re-enroll later, and you will lose coverage for those services in the meantime.

If you believe your premium deduction is incorrect, contact Social Security at 1-800-772-1213 or visit your local Social Security office with your SSDI payment statement and Medicare documents. Social Security handles the deduction, not Medicare, so Social Security is the correct agency to contact about billing problems.

Frequently Asked Questions

Can I get my Medicare premiums reduced if I have low income?

Yes. The Medicare Savings Program, run by your state, can pay your Part B premium and other costs if your income and resources are below your state's limits. You explore through your state Medicaid office, not through Social Security. The Low-Income Subsidy program can also reduce your Part D premium if you may have access to. Call 1-800-772-1213 to learn about both programs.

What happens if I cannot afford my Medicare premiums?

Contact Social Security when ready at 1-800-772-1213 or visit your local office. Explain your situation and ask about the Medicare Savings Program and Low-Income Subsidy. You can also request a Life-Changing Event appeal if your circumstances have recently changed. Do not ignore premium bills — unpaid premiums can result in coverage gaps and penalties.

Do I have to enroll in Part D when I first get Medicare?

No, Part D is optional. However, if you delay enrollment without having other creditable drug coverage, you will pay a permanent late enrollment penalty when you do sign up. If you do not take prescription medications, you may choose not to enroll, but understand that re-enrolling later will cost more.

Will my SSDI payment increase if my Medicare premiums go down?

Yes. If your Medicare premiums decrease, your SSDI payment will increase by the same amount because the deduction is smaller. Conversely, if premiums increase, your SSDI payment decreases. Social Security automatically adjusts your payment each January when new Medicare premiums take effect.

How do I know if I am paying IRMAA?

Your Social Security statement and Medicare notices will show if you are paying IRMAA. You will see higher Part B and Part D premiums listed than the standard amount. If you believe your income has changed significantly since the calculation was made, call Social Security at 1-800-772-1213 to request a recalculation based on a Life-Changing Event.